Story Highlights

As the NFL kicks off its season Thursday night in Denver, the game is quite different from what it was just a few years ago. Brain injuries, once ignored, are now taken seriously. Commissioner Roger Goodell has thrown quite at lot at the problem, even in the face of critics who insist he is "sissifying" pro football.

For years, concussed players were rushed back into games. Now, any lingering symptom is supposed to keep them out until an independent consultant clears them. Lengthy suspensions — a full season for New Orleans coach Sean Payton — were imposed on leaders of a bounty system that rewarded players for injuring opponents. A gaggle of new rules are aimed at preventing cheap shots and head trauma, including one this season barring players from leading with the crown of their helmets.

So give the NFL credit for change, but keep in mind this reformation didn't spring solely from altruism. It wouldn't have happened without pressure from Congress, scorching publicity, suicides by several ex-players and a massive lawsuit charging that the league misled players about the long-term dangers of concussions. Just a week ago, the NFL agreed to settle the suit for $765 million over 20 years — not a huge hit for a business with nearly $10 billion in revenue last year, but not chump change either.

As evidence mounts that permanent brain damage and dementia are legacies of some still-unknown number of NFL careers, the league faces a dilemma: Bone-jarring hits are an unavoidable part of football, but if the game gets too brutal, fans and the parents of prospective players could abandon it. Several former NFL stars have said they wouldn't let their sons play. Participation in youth leagues is down.

While the NFL, which sets the tone for college and youth players, has made significant strides, more can be done to reduce brain injuries:

Rules are only as good as their enforcement. Since declaring in 2010 that it would come down hard on even first-time hits to the head and neck, the NFL has suspended just two offenders — each for a single game. For one of them, James Harrison, it was his fifth offense against a quarterback.

The laws of physics say that hits by bigger, stronger, faster players do more damage, and the number of supersized players has grown exponentially in recent years. Instead of pushing to test for human growth hormone, or HGH, the NFL Players Association has dragged its feet on a testing regime.

Boston University researchers, studying the brains of 34 deceased NFL players, recently found that 33 had the same degenerative brain disorder. Young brains are particularly vulnerable to the ravages of concussions, and more research is needed, as is better helmet technology.

Another area ripe for improvement is the attitude of some sports media, fans and players who celebrate the most bell-ringing hits and treat players like characters in video game fantasies.

Making an inherently violent game less dangerous won't be easy. How to measure success? If there's no need for another huge settlement 20 years from now.

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